Risk of Early Childhood Dental Caries Associated With Prolonged Breastfeeding: A Systematic Review and Meta-Analysis

Abstract

Background: Breastfeeding provides essential nutrients and benefits for newborns. However, its prolonged duration has raised concerns about potential risks for early childhood caries (ECC). Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children under 71 months. Design: Eligibility criteria included observational studies comparing ECC risk in children breastfed for over 12 months, with no language restrictions. Databases searched included PubMed, Scopus, and others, up to May 17, 2024. Risk of bias was assessed using the JBI Critical Appraisal Checklist. Meta-analyses were performed using a random-effects model. Results: Twenty-five studies involving 19 681 participants were included. Studies showed an increased risk of ECC in children breastfed for more than 24 months (RR = 2.44; 95% CI, 1.97 to 3.02). For the 12–24 months period, no significant risk increase was found. Meta-analyses also indicated higher ECC prevalence with breastfeeding beyond 12 months (OR = 1.86; 95% CI, 1.48 to 2.35). Conclusion: Prolonged breastfeeding beyond 24 months is associated with an increased risk of ECC. This review highlights the need for future studies to address current research limitations and better understand the relationship between prolonged breastfeeding and ECC. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO): CRD42024509212.